October 26, 2017
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Patients with cancer history receive less care for acute MI

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Guideline-recommended treatment for acute MI was given less to patients who had a history of cancer, according to a study published in European Heart Journal: Acute Cardiovascular Care.

“It is well-known that cancer patients may have an increased risk of cardiovascular disease as a result of their treatment,” Dragana Radovanovic, MD, head of AMIS Plus Data Center in Zurich, said in a press release. “However ... little is known about the treatment and outcomes of cancer patients who have an acute myocardial infarction.”

Sabine Rohrmann , P h D, MPH, of the division of chronic disease epidemiology at the University of Zurich, and colleagues analyzed data from 35,249 patients who had an acute MI (STEMI or non-STEMI) from the AMIS Plus registry in Switzerland. Among the cohort, 5.6% had a history of cancer.

Patients with and without a history of cancer had different baseline characteristics, including STEMI, age, BMI, diabetes, hypertension and smoking. Most of the differences disappeared after propensity-score matching except for BMI and differences in MI risk factors.

PCI was performed less in patients with a history of cancer vs. those without a history (OR = 0.76; 95% CI, 0.67-0.88). Patients with a history of cancer were given P2Y12 blockers (OR = 0.82; 95% CI, 0.71-0.94) and statins (OR = 0.87; 95% CI, 0.76-0.99) less frequently compared with those without a history of cancer.

Complications during hospitalization occurred more often in patients with a history of cancer vs. those without a history. The rate of in-hospital mortality was higher in patients with a history of cancer (OR = 1.45; 95% CI, 1.17-1.81) compared with those who did not have a history of cancer. Cardiac death was the main cause of mortality for both groups and did not significantly differ between them (OR = 0.68; 95% CI, 0.37-1.25).

“Numerous advances in the treatment of [acute] MI have occurred over the past few decades, and treatment of [acute] MI patients in Switzerland has substantially changed over the past 15 years in accordance with the recommended guidelines of evidence-based medicine,” Rohrmann and colleagues wrote. “However, [acute] MI remains an important cause of mortality and morbidity in the general population worldwide, and the application of evidence-based therapies for STEMI patients in real-world practice continues to be inconsistent, particularly for vulnerable populations such as women or the elderly.” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.